About the Greece Response Program



According to the International Rescue Committee, there are 62,000 refugees currently in Greece and over half of them are women and children.  The demographics of the population require specialty care regarding infant and young child feeding (IYCF) and support for pregnant and lactating women. While a significant amount of resources have flooded the area since the beginning of the crisis, challenges still remain in adequately addressing individual needs.  With the Balkan countries closing their borders in early March 2017, this refugee population remains stranded in Greece for the foreseeable future.

NPI is uniquely positioned to respond with quality care that begins to build a supportive community for mothers and their children. Displacement makes life difficult and even more so for pregnant women and mothers of young children.  Child rearing is best done in a supportive environment, and because NPI focuses on building relationships and empowering mothers, it establishes that support in the absence of the typical familial and community support that these mothers deserve.  Furthermore, NPI is dedicated to strict enforcement of policies and procedures that ensure supported breastfeeding and appropriate handling of breastmilk substitutes (BMS).  The pervasiveness of the lack of knowledge regarding the distribution of BMS in this crisis reinforces the need for NPI’s presence in Greece.

NPI has responded with flexibility to the ever-changing climate in Greece. Between the months of December 2016 and February 2017, large numbers of refugees and migrants were relocated from Kalochori and Sindos camps into hotels and flats in and around Thessaloniki. This switch has necessitated that NPI move from a set place in the camps to a mobile unit approach. At the end of December 2016, NPI began discussions with the Ministry of Migration and Policy, UNHCR, NRC, as well as other organizations to obtain access to hotels and flats in order to continue providing services to refugees/migrants. After a few months of negotiations, in February 2017, NPI received access to provide IYCF services in 13-15 sites (hotels/flats). 

Program Rationale

The Greece Response Program addresses a significant need among refugees/migrants in Greece for support in breastfeeding and infant health. Comprehensive, research-based evidence exists that confirms breastfeeding as a successful intervention to improve maternal health and to reduce infant mortality, particularly during situations of humanitarian crisis. Infants are extremely vulnerable in emergencies, with mortality rates skyrocketing during crisis, often a result of heightened risk of diarrheal illness which is one of the major causes of mortality in children under 5 years old.

Outbreaks of diarrhea in infants and young children are common in emergencies as a result of food insecurity, unclean water, overcrowding, and limited access to quality medical treatment. 
Providing support, particularly from trained health professionals, for good infant feeding practices drastically increases the chance of infants surviving emergencies. These feeding practices are comprised of exclusive breastfeeding for the first six months of life, with the addition of complementary feeding after the first six months. Breastfeeding provides protection specifically against diarrheal illnesses by supplying a safe, readily available food and water supply in addition to protection for the infant against bacterial and viral infections. Infants who are fed with infant formula are at increased risk of diarrhea because they can be exposed to pathogens in powdered milk substitutes or contaminated water. However, women in emergencies are often more susceptible to discontinuation of breastfeeding and introduction of formula feeding.

Despite much research confirming that protecting breastfeeding improves the health of mothers and babies, aid to breastfeeding is often undermined in humanitarian emergencies, primarily through poorly targeted, or in some cases, blanket distribution of breastmilk substitutes. This is evidenced in reports from humanitarian emergencies over the last decade when emergencies areas have been overwhelmed with donations of breastmilk substitutes. 

It is in this context that NPI seeks to provide ethically responsive, comprehensive services to support infant and maternal health for refugees/migrants. NPI works to meet the need for professionals who can sensitively address the individual needs of mothers to initiate and continue breastfeeding during cases of instability and insecurity. This includes a commitment to uphold mothers’ rights to breastfeed in accordance with the International Code on Marketing of Breastmilk Substitutes, which was put in place in 1981 to address the issues mentioned previously regarding poorly targeted distribution of formula during emergencies. NPI’s team of trained volunteers provides individualized support and care to mothers, beginning during pregnancy, to make the choices which will result in the healthiest and best outcomes for themselves and their children. This includes the provision of formula in medically indicated cases and support for re-lactation where possible.